HCPCS L2186: Addition to Lower Extremity Fracture Orthosis, Adjustable Motion Knee Joint

HCPCS Level II code L2186 denotes an addition to a lower extremity fracture orthosis consisting of an adjustable motion knee joint (Lerman type) used to provide controlled knee motion and stability as part of an orthotic brace; the service is an orthotic device component typically provided in outpatient orthotics/prosthetics clinics, durable medical equipment suppliers, or outpatient orthopedic settings.

Customize your policy alerts

Sign up for hcpcs L2186 policy alerts

Get alerted when payer policies referencing L2186 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Explore openpayer tools

View all tools

HCPCS L2186: Addition to Lower Extremity Fracture Orthosis, Adjustable Motion Knee Joint

Customize your policy alerts

Sign up for hcpcs L2186 policy alerts

Get alerted when payer policies referencing L2186 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

Clinical & Coding Specifications

Clinical Context

A 42-year-old male presents after a low-energy fall with a displaced distal tibia fracture extending to the ankle. The orthopedic surgeon determines operative fixation is not indicated initially or the patient is managed nonoperatively; a prefabricated lower extremity fracture orthosis is selected. During fitting, the clinician elects to add an adjustable motion knee joint (Lerman type) to control knee flexion/extension and permit staged range-of-motion during healing. The orthotist measures the limb, documents the addition of the adjustable motion knee joint as an accessory to the fracture orthosis, and records the device model, laterality RT or LT, medical necessity, and the expected duration of use.

Workflow steps:

Initial orthopedic evaluation and imaging confirm fracture and conservative management plan.
Ordering clinician prescribes a lower extremity fracture orthosis with an adjustable motion knee joint accessory (L2186).
Certified orthotist performs fitting, documents measurements, adjustment settings, and patient education on joint locking and ROM limits.
Claims submission includes the base orthosis code (as applicable), the addition code L2186 with appropriate modifier(s) for laterality and circumstance, and the treating diagnosis code(s) supporting medical necessity.
Follow-up visits assess skin integrity, joint function, and adjust motion settings per surgeon protocol.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`29515`	Application of a short-leg walking cast, trauma; primary, static	May be performed as an alternative initial immobilization prior to ordering a fracture orthosis accessory
`29305`	Application of short leg splint (includes walking cast-type)	Performed in the ED or clinic before definitive orthotic fitting
`97760`	Orthotic management and training, upper extremity, lower extremity, and/or trunk; initial orthotic evaluation	Used by therapists for initial training and gait/ADL instruction when the adjustable knee joint is added
`99070`	Supplies and materials (e.g., additional straps, padding), utilized during orthotic application, not included in service	Used to bill non-DME supply items associated with fitting the adjustable knee joint
`A9270`	Non-covered item or service (misc DME supply)	Occasionally used for miscellaneous orthotic components when no specific HCPCS exists

Related Modifiers

5 rows

Modifier	Description	When to Use
59	Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…	- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
81	Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…	- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…
55	Modifier –55 indicates the billing provider furnished only postoperative management for a procedure that has a global surgical period. According to AAPC, this modifier is appended to the same CPT…	- Use modifier -55 when billing the same CPT surgical code that has a 10- or 90-day global period and you, as a provider other than the original surgeon, furnished ONLY postoperative management (no…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207K00000X	Allergy & Immunology Physician	An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Select…
332B00000X	Durable Medical Equipment & Medical Supplies	A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for…
207L00000X	Anesthesiology Physician	An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
1835C0207X	Compounded Sterile Preparations Pharmacist	A licensed pharmacist who has demonstrated specialized knowledge and skill to ensure that sterile preparations meet the clinical needs of patients, sa…
207PS0010X	Sports Medicine (Emergency Medicine) Physician	An emergency physician with special knowledge in sports medicine is responsible for continuous care in the field of sports medicine, not only for the …
2086S0120X	Pediatric Surgery Physician	A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.
363LC1500X	Community Health Nurse Practitioner	Physician Assistants & Advanced Practice Nursing Providers · Nurse Practitioner
133V00000X	Registered Dietitian	A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of diet…

HCPCS L0112: Cranial Cervical Orthosis, Congenital Torticollis Type

HCPCS-L0113-CRANIAL-CERVICAL-ORTHOSIS-TORTICOLLIS

HCPCS Level II L0113: Prefabricated Cranial Cervical Orthosis for Torticollis

HCPCS-L0130-CERVICAL-FLEXIBLE-THERMOPLASTIC-COLLAR-MOLDED-TO-PATIENT

HCPCS Level II L0130: Cervical Flexible Thermoplastic Collar, Molded to Patient

HCPCS-L0140-CERVICAL-SEMI-RIGID-ADJUSTABLE-PLASTIC-COLLAR

HCPCS Level II L0140: Cervical Semi-Rigid Adjustable Plastic Collar

HCPCS-L0150-CERVICAL-SEMI-RIGID-ADJUSTABLE-CHIN-CUP

HCPCS Level II L0150: Cervical Semi-Rigid Adjustable Chin Cup

HCPCS-L0160-CERVICAL-SEMI-RIGID-OCCIPITAL-MANDIBULAR-SUPPORT

HCPCS Level II L0160: Cervical Semi-Rigid Occipital/Mandibular Support

HCPCS-L0170-CERVICAL-COLLAR-MOLDED-TO-PATIENT-MODEL

HCPCS Level II L0170: Cervical Collar, Custom-Molded

HCPCS-L0172-CERVICAL-COLLAR-SEMI-RIGID-THERMOPLASTIC-FOAM

HCPCS L0172: Cervical Collar, Semi-Rigid Prefabricated

HCPCS-L0174-CERVICAL-COLLAR-SEMI-RIGID-THORACIC-EXTENSION

HCPCS L0174: Cervical Collar, Semi-Rigid Thermoplastic with Thoracic Extension

HCPCS-L0180-CERVICAL-MULTIPLE-POST-COLLAR-OCCIPITAL-MANDIBULAR-ADJUSTABLE

HCPCS Level II L0180: Cervical Orthosis with Occipital/Mandibular Supports

Showing 1–10 of 466

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Explore openpayer tools

View all tools

Clinical & Coding Specifications

Clinical Context

Workflow steps:

Initial orthopedic evaluation and imaging confirm fracture and conservative management plan.
Ordering clinician prescribes a lower extremity fracture orthosis with an adjustable motion knee joint accessory (L2186).
Certified orthotist performs fitting, documents measurements, adjustment settings, and patient education on joint locking and ROM limits.
Claims submission includes the base orthosis code (as applicable), the addition code L2186 with appropriate modifier(s) for laterality and circumstance, and the treating diagnosis code(s) supporting medical necessity.
Follow-up visits assess skin integrity, joint function, and adjust motion settings per surgeon protocol.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`29515`	Application of a short-leg walking cast, trauma; primary, static	May be performed as an alternative initial immobilization prior to ordering a fracture orthosis accessory
`29305`	Application of short leg splint (includes walking cast-type)	Performed in the ED or clinic before definitive orthotic fitting
`97760`	Orthotic management and training, upper extremity, lower extremity, and/or trunk; initial orthotic evaluation	Used by therapists for initial training and gait/ADL instruction when the adjustable knee joint is added
`99070`	Supplies and materials (e.g., additional straps, padding), utilized during orthotic application, not included in service	Used to bill non-DME supply items associated with fitting the adjustable knee joint
`A9270`	Non-covered item or service (misc DME supply)	Occasionally used for miscellaneous orthotic components when no specific HCPCS exists

Related Modifiers

5 rows

Modifier	Description	When to Use
59	Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…	- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
81	Modifier -81 indicates a physician served as a minimal assistant surgeon for part—not all—of an operative procedure. Use when a physician’s assisting role is limited and does not represent full…	- Use CPT modifier -81 when a physician acts as a minimum assistant surgeon who assists during only part (a limited portion) of an operative procedure; append -81 to the primary surgical CPT code to…
55	Modifier –55 indicates the billing provider furnished only postoperative management for a procedure that has a global surgical period. According to AAPC, this modifier is appended to the same CPT…	- Use modifier -55 when billing the same CPT surgical code that has a 10- or 90-day global period and you, as a provider other than the original surgeon, furnished ONLY postoperative management (no…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
207K00000X	Allergy & Immunology Physician	An allergist-immunologist is trained in evaluation, physical and laboratory diagnosis, and management of disorders involving the immune system. Select…
332B00000X	Durable Medical Equipment & Medical Supplies	A supplier of medical equipment such as respirators, wheelchairs, home dialysis systems, or monitoring systems, that are prescribed by a physician for…
207L00000X	Anesthesiology Physician	An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
1835C0207X	Compounded Sterile Preparations Pharmacist	A licensed pharmacist who has demonstrated specialized knowledge and skill to ensure that sterile preparations meet the clinical needs of patients, sa…
207PS0010X	Sports Medicine (Emergency Medicine) Physician	An emergency physician with special knowledge in sports medicine is responsible for continuous care in the field of sports medicine, not only for the …
2086S0120X	Pediatric Surgery Physician	A surgeon with expertise in the management of surgical conditions in premature and newborn infants, children and adolescents.
363LC1500X	Community Health Nurse Practitioner	Physician Assistants & Advanced Practice Nursing Providers · Nurse Practitioner
133V00000X	Registered Dietitian	A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of diet…

HCPCS L0112: Cranial Cervical Orthosis, Congenital Torticollis Type

HCPCS-L0113-CRANIAL-CERVICAL-ORTHOSIS-TORTICOLLIS

HCPCS Level II L0113: Prefabricated Cranial Cervical Orthosis for Torticollis

HCPCS-L0130-CERVICAL-FLEXIBLE-THERMOPLASTIC-COLLAR-MOLDED-TO-PATIENT

HCPCS Level II L0130: Cervical Flexible Thermoplastic Collar, Molded to Patient

HCPCS-L0140-CERVICAL-SEMI-RIGID-ADJUSTABLE-PLASTIC-COLLAR

HCPCS Level II L0140: Cervical Semi-Rigid Adjustable Plastic Collar

HCPCS-L0150-CERVICAL-SEMI-RIGID-ADJUSTABLE-CHIN-CUP

HCPCS Level II L0150: Cervical Semi-Rigid Adjustable Chin Cup

HCPCS-L0160-CERVICAL-SEMI-RIGID-OCCIPITAL-MANDIBULAR-SUPPORT

HCPCS Level II L0160: Cervical Semi-Rigid Occipital/Mandibular Support

HCPCS-L0170-CERVICAL-COLLAR-MOLDED-TO-PATIENT-MODEL

HCPCS Level II L0170: Cervical Collar, Custom-Molded

HCPCS-L0172-CERVICAL-COLLAR-SEMI-RIGID-THERMOPLASTIC-FOAM

HCPCS L0172: Cervical Collar, Semi-Rigid Prefabricated

HCPCS-L0174-CERVICAL-COLLAR-SEMI-RIGID-THORACIC-EXTENSION

HCPCS L0174: Cervical Collar, Semi-Rigid Thermoplastic with Thoracic Extension

HCPCS-L0180-CERVICAL-MULTIPLE-POST-COLLAR-OCCIPITAL-MANDIBULAR-ADJUSTABLE

HCPCS Level II L0180: Cervical Orthosis with Occipital/Mandibular Supports

Showing 1–10 of 466

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

HCPCS L2186: Addition to Lower Extremity Fracture Orthosis, Adjustable Motion Knee Joint

Sign up for hcpcs L2186 policy alerts

OpenPayer

HCPCS L2186: Addition to Lower Extremity Fracture Orthosis, Adjustable Motion Knee Joint

Sign up for hcpcs L2186 policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

References

HCPCS L2186: Addition to Lower Extremity Fracture Orthosis, Adjustable Motion Knee Joint

Sign up for hcpcs L2186 policy alerts

HCPCS L2186: Addition to Lower Extremity Fracture Orthosis, Adjustable Motion Knee Joint

Sign up for hcpcs L2186 policy alerts

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

What does HCPCS code L2186 represent?

In what clinical scenario would L2186 be applied and what documentation is recorded?

What should be included on the claim when billing L2186?

Which modifiers are referenced for L2186 and when are they used?

What related CPT/ICD codes and payers are noted in the L2186 overview?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Codes

What does HCPCS code L2186 represent?

In what clinical scenario would L2186 be applied and what documentation is recorded?

What should be included on the claim when billing L2186?

Which modifiers are referenced for L2186 and when are they used?

What related CPT/ICD codes and payers are noted in the L2186 overview?

References